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Organization

ELLINGSEN -PAXTON DDS PS

Active
Other names
Ellingsen Paxton Johnson Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD C ELLINGSEN DDS (PRESIDENT)
(509) 926-0570
Entity
Organization

Contact information

Practice address
12109 E BROADWAY AVE STE B, SPOKANE VALLEY, WA 99206-6133
(509) 926-0570
(509) 921-9163
Mailing address
12109 E BROADWAY AVE STE B, SPOKANE VALLEY, WA 99206-6133
(509) 926-0570
(509) 921-9163

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
60083394
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE00005607
WA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00006352
WA

Other

Enumeration date
10/25/2006
Last updated
11/19/2009
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